NR 509 Final Exam
3 year old development - --pedals tricycle, jumps in place.
-balance on 1 foot at 4yo
- 8mo old child development - --say dada/mama
- indicate wants
-feeds self
-sit
-cant stand
- Abdomen assessment sequence - -Inspect, auscultate, and percuss
the abdomen. Palpate lightly, then deeply. Assess the liver and spleen by
percussion and then palpation. Try to palpate the kidneys. Palpate the
aorta and its pulsations. If you suspect kidney infection, percuss
posteriorly over the costovertebral angles.
- Appendicitis pain - -RLQ pain or pain that migrates from the
periumbilical region, combined with abdominal wall rigidity on palpation
- atopic dermatitis (eczema) - -Erythema, scaling, dry skin, and intense
itching
- Bacterial Vaginosis (BV) - --Caused by overgrowth of anaerobic
bacteria (often from sex)
- Discharge: Gray or white, thin, homogenous, malodorous, coats the
vaginal walls, usually not profuse, may be minimal
- Fishy/musty genital odor
-Normal vulva and vaginal mucosa
-Scan saline wet mount for clue cells (epithelial cells with stippled
borders); sniff for fishy odor after applying KOH ("whiff test"); test the
vaginal secretions for pH > 4.5
- Bleeding between periods - -Metrorrhagia
- Breast masses - -Most often found by women during self examination
- Buerger test (chronic arterial insufficiency) - -- Raise both legs to
about 90o for up to 2 minutes
- Then pt sits up with feet to the floor
- see how long it takes for color to return to feet (usually 10-15 seconds)
- Candidal Vaginitis - --Cause: Candida albicans, a yeast (normal
overgrowth of vaginal flora); many factors predispose, including antibiotic
therapy
, -Discharge: white and curdy, may be thin but usually thick, not as profuse
as trichomonal infection, not malodorous
- vaginal soreness, pruritus, pain on urination, dyspareunia (painful
intercourse)
-The vulva and surrounding skin are inflamed and sometimes swollen to a
variable extent; the vaginal mucosa is reddened, with white tenacious
patches of discharge; the mucosa may bleed when these patches are
scraped off; in mild cases, the mucosa looks normal
-Scan potassium hydroxide (KOH) preparation for the branching hyphae of
Candida
- cardiovascular ROS - -SOB, syncope, edema, chest pain, orthopnea
- Cause of incr JVP - --acute and chronic heart failure
-tricuspid stenosis
-chronic pulmonary hypertension
-superior vena cava obstruction
-cardiac tamponade
-constrictive pericarditis
- Causes of dk. bloody emesis - -Hematemesis may accompany
esophageal or gastric varices, Mallory-Weiss tears, or peptic ulcer disease.
- Chalazion - -A subacute nontender, usually painless nodule caused by
a blocked meibomian gland. May become acutely inflamed but, unlike a
stye, usually points inside the eyelid rather than on the lid margin.
- Characteristics of a breast cyst - -Soft to firm, round, mobile, often
tender.
- cricoid cartilage - -
- Diverticulitis pain - --LLQ
-cramping at first, then steady
- gradual onset
- tx: analgesia, bowel rest, abx
- sx: fever, constipation, n/v
- Epigastric pain - -Epigastric pain occurs with GERD, pancreatitis, and
perforated ulcers. RUQ and upper abdominal pain are common in
cholecystitis and cholangitis
- Erectile dysfunction - -In a 47 yo male, it is most often psychologic and
not testosterone related.
- Forms of urinary incontinence - --Stress: Increased abdominal pressure
causes bladder pressure to exceed urethral resistance—there is poor
urethral sphincter tone or poor support of bladder neck.
3 year old development - --pedals tricycle, jumps in place.
-balance on 1 foot at 4yo
- 8mo old child development - --say dada/mama
- indicate wants
-feeds self
-sit
-cant stand
- Abdomen assessment sequence - -Inspect, auscultate, and percuss
the abdomen. Palpate lightly, then deeply. Assess the liver and spleen by
percussion and then palpation. Try to palpate the kidneys. Palpate the
aorta and its pulsations. If you suspect kidney infection, percuss
posteriorly over the costovertebral angles.
- Appendicitis pain - -RLQ pain or pain that migrates from the
periumbilical region, combined with abdominal wall rigidity on palpation
- atopic dermatitis (eczema) - -Erythema, scaling, dry skin, and intense
itching
- Bacterial Vaginosis (BV) - --Caused by overgrowth of anaerobic
bacteria (often from sex)
- Discharge: Gray or white, thin, homogenous, malodorous, coats the
vaginal walls, usually not profuse, may be minimal
- Fishy/musty genital odor
-Normal vulva and vaginal mucosa
-Scan saline wet mount for clue cells (epithelial cells with stippled
borders); sniff for fishy odor after applying KOH ("whiff test"); test the
vaginal secretions for pH > 4.5
- Bleeding between periods - -Metrorrhagia
- Breast masses - -Most often found by women during self examination
- Buerger test (chronic arterial insufficiency) - -- Raise both legs to
about 90o for up to 2 minutes
- Then pt sits up with feet to the floor
- see how long it takes for color to return to feet (usually 10-15 seconds)
- Candidal Vaginitis - --Cause: Candida albicans, a yeast (normal
overgrowth of vaginal flora); many factors predispose, including antibiotic
therapy
, -Discharge: white and curdy, may be thin but usually thick, not as profuse
as trichomonal infection, not malodorous
- vaginal soreness, pruritus, pain on urination, dyspareunia (painful
intercourse)
-The vulva and surrounding skin are inflamed and sometimes swollen to a
variable extent; the vaginal mucosa is reddened, with white tenacious
patches of discharge; the mucosa may bleed when these patches are
scraped off; in mild cases, the mucosa looks normal
-Scan potassium hydroxide (KOH) preparation for the branching hyphae of
Candida
- cardiovascular ROS - -SOB, syncope, edema, chest pain, orthopnea
- Cause of incr JVP - --acute and chronic heart failure
-tricuspid stenosis
-chronic pulmonary hypertension
-superior vena cava obstruction
-cardiac tamponade
-constrictive pericarditis
- Causes of dk. bloody emesis - -Hematemesis may accompany
esophageal or gastric varices, Mallory-Weiss tears, or peptic ulcer disease.
- Chalazion - -A subacute nontender, usually painless nodule caused by
a blocked meibomian gland. May become acutely inflamed but, unlike a
stye, usually points inside the eyelid rather than on the lid margin.
- Characteristics of a breast cyst - -Soft to firm, round, mobile, often
tender.
- cricoid cartilage - -
- Diverticulitis pain - --LLQ
-cramping at first, then steady
- gradual onset
- tx: analgesia, bowel rest, abx
- sx: fever, constipation, n/v
- Epigastric pain - -Epigastric pain occurs with GERD, pancreatitis, and
perforated ulcers. RUQ and upper abdominal pain are common in
cholecystitis and cholangitis
- Erectile dysfunction - -In a 47 yo male, it is most often psychologic and
not testosterone related.
- Forms of urinary incontinence - --Stress: Increased abdominal pressure
causes bladder pressure to exceed urethral resistance—there is poor
urethral sphincter tone or poor support of bladder neck.
